ImportanceMajor depressive disorder is one of the most common mental disorders among adolescents, entailing severe, long-term psychosocial impairment and a high risk of chronicity. In view of the large number of patients requiring treatment, along with insufficient treatment responses with small effect sizes, innovative adjunctive treatment strategies are urgently needed.ObjectiveTo investigate whether the effect of adolescent psychiatric inpatient treatment as usual for major depressive disorder can be enhanced by simultaneous use of morning bright light therapy.Design, Setting, and ParticipantsThis was a double-blind, placebo-controlled randomized parallel-group trial with enrollment between March 2018 and November 2020 and follow-up completed in May 2021. The study took place among inpatients at 4 university hospitals for child and adolescent psychiatry across Germany. Of 248 eligible youth aged 12 to 18 years fulfilling ICD-10 criteria for major depressive disorder, 227 were randomized to bright light therapy (n = 116) or placebo red light (n = 111); 151 participants completed the study.InterventionsUp to 20 sessions of either morning bright light therapy with an intensity of 10 000 lux or placebo red light (100 lux) in addition to multimodal inpatient treatment as usual over 4 weeks.Main Outcomes and MeasuresThe primary outcome was the change in Beck Depression Inventory-II (BDI-II) score from baseline to posttreatment in the intention-to-treat sample.ResultsAmong the 224 patients included in the intention-to-treat analyses (192 girls and 32 boys; mean [SD] age, 15.5 [1.4] years), the mean (SD) BDI-II score at baseline was 37.3 (8.7). BDI-II scores were significantly reduced after 4 weeks (postassessment) by a mean of −7.5 (95% CI, −9.0 to −6.0; Hedges g = 0.71). Bright light therapy had no impact on this change (no significant group × time effect). Loss to follow-up was 31% (n = 69) at 16 weeks and 49% (n = 110) at 28 weeks. There were 10 serious adverse events throughout the whole trial, which were not considered related to study treatment.Conclusions and RelevanceThe findings in this study did not indicate superiority of bright light therapy over placebo red light therapy in a large sample of adolescent inpatients with moderate or severe major depressive disorder. Both groups benefited equally from treatment as usual, showing relevant symptom reduction.Trial RegistrationGerman Clinical Trials Register: DRKS00013188

中文翻译：

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亮光疗法作为青少年中度至重度抑郁症住院治疗的附加治疗


重要性重度抑郁症是青少年中最常见的精神障碍之一，会导致严重的、长期的心理社会障碍和慢性病的高风险。鉴于需要治疗的患者数量众多，以及疗效不足且效应量小，迫切需要创新的辅助治疗策略。目的探讨同时采用晨光疗法是否能增强青少年精神科住院治疗重度抑郁症的疗效。设计、设置和参与者这是一项双盲、安慰剂对照的随机平行组试验，于 2018 年 3 月至 2020 年 11 月入组，随访于 2021 年 5 月完成。该研究在德国 4 所儿童和青少年精神病学大学医院的住院患者中进行。在 248 名符合 ICD-10 重度抑郁症标准的 12 至 18 岁符合条件的青少年中，227 名被随机分配到亮光疗法 （n = 116） 或安慰剂红光治疗 （n = 111）;151 名参与者完成了这项研究。干预除了在 4 周内照常进行多模式住院治疗外，最多 20 次强度为 10 000 勒克斯的晨光疗法或安慰剂红光疗法（100 勒克斯）。主要结局和措施主要结局是意向治疗样本中贝克抑郁量表-II （BDI-II） 评分从基线到治疗后的变化。结果在意向治疗分析纳入的 224 例患者中 （192 例女孩和 32 例男孩;平均 [SD] 年龄，15.5 [1.4] 岁），基线时的平均 （SD） BDI-II 评分为 37.3 （8.7）。4 周后（评估后）BDI-II 评分显著降低，平均降低 -7.5 （95% CI，-9.0 至 -6.0;对冲 g = 0.71）。 亮光疗法对这种变化没有影响 （组×时间效应没有显著的影响）。16 周时失访率为 31% （n = 69），28 周时失访率为 49% （n = 110）。整个试验中有 10 例严重不良事件，这些不良事件被认为与研究治疗无关。结论和相关性本研究的结果并未表明在患有中度或重度重度抑郁症的青少年住院患者的大样本中，亮光疗法优于安慰剂红光疗法。两组都从常规治疗中获益相同，显示出相关症状减轻。试验注册德国临床试验注册库： DRKS00013188